Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Two-dimensional global longitudinal strain is superior to left ventricular ejection fraction in prediction of outcome in patients with left-sided infective endocarditis

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Early diastolic strain rate in relation to long term prognosis following isolated coronary artery bypass grafting

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. The impact of peripheral artery disease on major adverse cardiovascular events following myocardial infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Computational simulation models to test bioprosthetic aortic valves: A valuable alternative or addition to bench testing?

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Aortic angle distribution and predictors of horizontal aorta in patients undergoing transcatheter aortic valve replacement

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Biomarkers of Cerebral Injury for Prediction of Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Changes in left atrial structure and function over a decade in the general population

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Left atrial strain predicts incident atrial fibrillation in the general population: the Copenhagen City Heart Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Early diastolic strain rate in relation to long term prognosis following isolated coronary artery bypass grafting

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Impaired cardiac function is the main predictor of poor outcome in infective endocarditis (IE). Global longitudinal strain (GLS) derived from two-dimensional strain echocardiography has proven superior in prediction of long-term outcome as compared to left ventricular ejection fraction (LVEF) in valvular disease and heart failure in general. Whether measurements of cardiac deformation can predict survival in patients with IE has not previously been investigated.

METHODS: The study included consecutive patients with Duke definite IE who underwent transthoracic and transesophageal echocardiography within 7 days. Clinical and echocardiographic markers associated with 1-year survival were identified using a Cox-proportional hazards model that included propensity adjustment for surgery. Reclassification statistics including receiver operating characteristic curves and net reclassification improvement were applied to LVEF and GLS, respectively.

RESULTS: A cohort of 190 patients met eligibility criteria. LVEF and GLS were both prognostic markers of mortality. Independent markers of 1-year mortality were S. aureus IE (HR:2.02; 95%CI 1.11-5.72, p = .022), diabetes (HR:2.05; 95%CI 1.12-3.75, p = .020), embolic stroke (HR:3.95; 95%CI 1.93-8.10, p < .001) and LVEF<45% (HR: 3.02; 95% CI 1.70-5.38, p < .001), GLS> -15.4% (HR:2.95; 95%CI 1.52-5.72, p < .001). Adding LVEF<45% to a model with known risk factors of IE did not significantly improve risk classification, whereas addition of GLS to the model resulted in significant increase (AUC = 0.763, p < .001).

CONCLUSIONS: When treatment was taken into account, LVEF<45% and GLS > -15.4% were both associated with adverse long-term outcome in left-sided IE. GLS >-15.4 % was significantly associated with 1-year mortality in the multivariate analysis. Further, GLS was superior to LVEF in risk prediction and risk discrimination of long-term outcome in patients with left-sided IE.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume260
Pages (from-to)118-123
Number of pages6
ISSN0167-5273
DOIs
Publication statusPublished - 1 Jun 2018

ID: 54607982